The overall goal for the Core is to facilitate the translation of results from basic mechanistic studies which are a component of each of the SCoR Projects into a greater understanding of the pathophysiology of human heart failure syndromes. Basic investigations at the molecular, cellular or organ level are complemented by the ability to identify in a well characterized human heart failure population genetic defects in or abnormal expression of candidate hypertrophy transducer or effector molecules targeted for study in this SCOR. A focus of the Clinical Core is the four year old Cincinnati Heart Failure Study, a longitudinal study of heart failure patients in the University of Cincinnati Heart Failure and Transplantation Program wherein clinical characteristics, genotypic analysis, physiological studies, and information on clinical course are acquired, archived analyzed and made available to the SCOR Project Leaders. Accordingly, the relevant objectives of the Core for Individual Projects are: 1) To screen, recruit, and perform the clinical characterization of early (NYHA Class I or II) and late (NYHA Class III or IV) heart failure patients for genetic analysis; 2) To perform invasive and non-invasive hemodynamic analysis of subjects with defined genetic betaAR or PLB polymorphisms; 3) To acquire, store, and distribute cardiac tissue from explanted failing hearts at cardiac transplantation and harvested non-failing hearts not used for transplantation; 4) To acquire epicardial patch biopsies from explanted failing or non-failing hearts of patients undergoing coronary artery bypass procedures. The Core thus not only provides access at multiple levels to a local population of Heart Failure Patients, but also acts as a consultative service in the design of appropriate hypothesis-testing studies within the patient population or on individual patients, in a manner which maximizes scientific return without compromising patient care.